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Potential damage to ovarian reserve from laparoscopic electrocoagulation in endometriomas and benign ovarian cysts: a systematic review and meta-analysis.
Lin, Yu-Hsuan; Hsia, Li-Hsin; Huang, Yun-Yao; Chang, Hao-Jung; Lee, Tsung-Hsien.
Afiliación
  • Lin YH; Department of Obstetrics and Gynecology, South District, Chung Shan Medical University Hospital, No. 110, Section 1, Jianguo N Rd, Taichung City, 402, Taiwan (R.O.C.).
  • Hsia LH; Department of Obstetrics and Gynecology, South District, Chung Shan Medical University Hospital, No. 110, Section 1, Jianguo N Rd, Taichung City, 402, Taiwan (R.O.C.).
  • Huang YY; Department of Obstetrics and Gynecology, South District, Chung Shan Medical University Hospital, No. 110, Section 1, Jianguo N Rd, Taichung City, 402, Taiwan (R.O.C.).
  • Chang HJ; Institute of Medicine, Chung Shan Medical University, Taichung City, 402, Taiwan (R.O.C.).
  • Lee TH; Department of Obstetrics and Gynecology, South District, Chung Shan Medical University Hospital, No. 110, Section 1, Jianguo N Rd, Taichung City, 402, Taiwan (R.O.C.).
J Assist Reprod Genet ; 41(10): 2727-2738, 2024 Oct.
Article en En | MEDLINE | ID: mdl-39145875
ABSTRACT

PURPOSE:

Laparoscopic cystectomy for ovarian endometriomas and benign ovarian cysts is often conducted through hemostatic methods, with bipolar electrocoagulation as a common approach. This study evaluated the impact of electrocoagulation, primarily through bipolar energy, versus nonthermal hemostatic methods on ovarian reserve in patients undergoing laparoscopic cystectomy for ovarian endometriomas and benign ovarian cysts.

METHODS:

A systematic review with meta-analysis was conducted by searching the Cochrane Library, PubMed, EMBASE, and Web of Science databases. Randomized controlled trials (RCTs) comparing the impact of nonthermal hemostatic methods and electrocoagulation on the ovarian reserve during laparoscopic cystectomy were included. The Cochrane Risk of Bias Tool for Randomized Controlled Trials (ROB 2.0) was utilized to assess the quality of the included studies. The meta-analysis included 13 RCTs involving 1043 patients. Postoperative serum anti-Müllerian hormone (AMH) levels and antral follicle counts (AFCs) were analyzed using Review Manager ver. 5.4.

RESULTS:

Compared with the bipolar group, patients with endometriomas in the nonthermal hemostatic group exhibited significantly higher postoperative AMH levels at 1, 3, 6, and 12 months. Conversely, no significant differences in AMH levels were observed in patients with benign ovarian cysts. Similarly, AFCs showed no significant differences, except for lower postoperative AFCs in patients with endometrioma in the electrocoagulation group.

CONCLUSION:

Nonthermal hemostatic methods are associated with more effective preservation of the ovarian reserve compared with bipolar electrocoagulation in laparoscopic cystectomy for ovarian endometriomas. However, no significant impact of bipolar electrocoagulation on the ovarian reserve was observed in patients with benign ovarian cysts. TRIAL REGISTRATION Registered in PROSPERO on April 10, 2023; ID # CRD42023413158.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Quistes Ováricos / Laparoscopía / Electrocoagulación / Endometriosis / Reserva Ovárica Límite: Female / Humans Idioma: En Revista: J Assist Reprod Genet Asunto de la revista: GENETICA / MEDICINA REPRODUTIVA Año: 2024 Tipo del documento: Article Pais de publicación: Países Bajos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Quistes Ováricos / Laparoscopía / Electrocoagulación / Endometriosis / Reserva Ovárica Límite: Female / Humans Idioma: En Revista: J Assist Reprod Genet Asunto de la revista: GENETICA / MEDICINA REPRODUTIVA Año: 2024 Tipo del documento: Article Pais de publicación: Países Bajos